Acne:  It’s Not Just For Teenagers Anymore

Although acne typically affects many teens, both male and female, adult acne is on the rise especially for women.  Some of the latest surveys show that 55% of new patients being treated for skin problems are adult females.  More on that statistic in just a moment.  First, though, I am sure many of you want to know the when, where, hows, and whys of this problem.When adult acne occurs, it lasts longer and usually does not resolve spontaneously without treatment.  The adult breakouts tend to center on the chin, jawline and neck.  Disturbingly, such breakouts occur when an adult is in his or her 20’s, and could potentially last well into his or her mid-40’s.  Many of these adult acne sufferers also did not necessarily have breakouts as teens.Many factors can lead to adult acne.  While one factor alone may be to blame in some circumstances, it is usually a combination of factors for most adults .  Stress is a major factor, as it stimulates the hormonal systems which in turn activate the sebaceous glands, providing a growth medium for skin bacteria.  Studies have in fact shown increased levels of acne in women with high stress and fast paced jobs.  Women also tend to have more papules (large red areas that don’t come to a head) which are painful and look very angry and inflamed.Women tend to outnumber men in adult acne as opposed to other way around in the teenage years.  In adult females, acne breakouts also occur during times of hormone fluctuations such as ovulation, menstrual periods, pregnancy and menopause.  I have seen many cases where changes in oral contraceptive types or stopping “the pill” can trigger acne also.Many experts also blame environmental triggers such as foods treated with hormones, air pollution, and products that come in contact with our skin that can increase inflammation (depending on one’s allergies).  Many supposedly “safe” skin treatments found over-the-counter in drugstores and supermarket can promote skin inflammation in sensitive patients.  Such products can contain skin dehydration elements such as alcohol.  Also, many people find that their skin gets more sensitive as they gets older due to damage over the years.After this rather depressing news, you may be saying to yourself, “Dr. Burke, what do I do now?”.  In the next blog post, I will outline in more detail specific ingredients and treatments that can reverse and eliminate this pesky problem especially facing adult women. In the meantime, if you go to the acne products section of our website, I have a number of safe but effective products that I recommend for adult and teen acne.  These products are very compatible with sensitive skin and laser-treated patients.Next time, I will also discuss other new, cutting-edge treatments that I am considering adding to our menu of care for the age-old and still frustrating problem of acne.  Meanwhile, feel free to call or e-mail us with any pressing skin care questions you may have.

Keeping Up Appearances in a Down Economy

Despite the current economic climate, more women and men than ever are undergoing appearance-enhancing procedures such as Botox, Juvederm/Restylane injections, and laser treatments to maintain their aesthetic regimen.  Many other patients are forgoing expensive facelifts and other plastic surgeries to opt for less costly and less permanent changes to their appearance.According to a recent article in the Wall Street Journal, 75% of the aesthetic physicians surveyed reported an increased demand for minimally invasive (or non-surgical) procedures such as Botox, fillers, and laser treatments in 2008 alone.   Surgeries such as breast augmentation and nose reshapings dropped dramatically at the same time.  Additionally, many patients described their use of such non-surgical treatments as “maintenance”, “like comfort food” and “part of my cost of doing business” (the article’s words, not mine).So why is this story significant?  Why exactly are more people trying minimally invasive procedures over other surgeries?  It may be because patients such as yourselves are aware of the potential dangers of invasive surgeries.  More than that though, people are also becoming more aware of cost differentials, especially with all the unavoidable economic news making daily headlines.  Whereas the average cost of Botox is $300-$400, and fillers $900-$1000, other surgeries such as facelifts can cost as much as $15,000, and that bill is almost never covered by health insurance either.  Besides these obvious differences in cost and convenience, patient satisfaction really speaks for itself.Here at Maine Laser Skin Care, I have seen amazing growth in such procedures in the past year.  Botox use increased 65%, and Juverderm went up 300% in the past year due in no small part to the reasons listed above.  I’m also proud to report that our office ranks as 3rd in the state of Maine and in the top 20 for all of New England–not bad for a business based in rural Maine.  I owe this good news to you all who have continued to support us, and have given us great feedback and suggestions that we have made it a point to follow up with.As always, with the winter upon us, don’t forget to moisturize and sun block (yes, even in winter) to protect your largest organ–YOUR SKIN.  Drink lots of fluids, and call us with any questions or to discuss any of our treatments.Note:  This entry was originally written as an e-newsletter exclusively for our subscribers on January 11, 2009.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have.

Sunscreen Basics

Despite the abundance of information out there about sunscreens, there is still much confusion among the public and even the popular press about the importance of using it regularly.  Therefore, at the risk of sounding like a broken record, here are some basic, but vital, facts about sunscreen that are frequently forgotten, ignored or not well known:

1. Sunscreens do exactly what the name says: They screen the sun, but cannot completely block it.  Therefore, their strengths are limited, and the importance of reapplication every so often is commonly overlooked.
2. One should always use sunscreens that contain both UVA and UVB protection.
3. For best results year-round, use sunscreen as part of your every morning routine no matter what time of year and type of weather.  Autumn is no exception, and winter especially poses a higher risk of sunburn than many realize.
4. When planning to be outdoors for lengthy periods, it is best to apply sunscreen at least 30 minutes before leaving the house.
5. Even so-called waterproof sunscreens will come off in water or with perspiration over time.  With this in mind, see Fact #6 below.
6. When swimming or perspiring with exercise outdoors, it is recommended that you reapply sunscreen every hour.
7. Always apply sunscreen over the backs of the hands, the neck, tops of the ears, and (for bald or balding men) the top of the head.  These are common areas of skin cancer growth and photoaging, and should avoid sun exposure as much as possible.
8. If you use a moisturizer or makeup with sunscreen in it, make sure the SPF rating is at least 30, especially for facial use.
9. Regardless of the amount of sunscreen used, try to avoid sun exposure during the peak UV exposure times of 10 A.M. to 2 P.M.
10. The best sunscreen in the world (see our product line) won’t work if you don’t use it regularly, or properly for that matter.  Make it a daily habit, like brushing your teeth or combing your hair.

Also, I have said many times in this blog that it is far easier to prevent sun damage in the first place, than to repair its effects afterwards.  We have the technology to repair much of the damage, but simple prevention is far less expensive.  So go out there, have fun, and take special care of your largest organ–your skin. Thanks again for reading this, and for your consistent support!  We will keep providing you with our great customer service.

Botox Update II

I was presented with some very good news recently which you may be interested in. I met with a representative from Allergan- the pharmaceutical company that makes Botox and Juvaderm.  She brought along some amazing information concerning the use of those products in my practice.  I’m proud to say that I currently rank in the Top 20 of all the aesthetic doctors in New England who use Botox and Juvaderm.  I also rank 3rd in the state of Maine. This is all the more amazing as many of the other skin doctors are in much more populated areas such as Portland, Maine, Burlington, Vermont and Portsmouth/Manchester/Concord, New Hampshire. The number of people who use Botox has still been growing, but due to the hit the economy took, that growth has actually slowed down to 10% per year in the U.S. and to 4% per year in New England.  However, Maine Laser’s growth alone has stayed at over 50% per year every year since we started using Botox four years ago.  Our patient satisfaction scores and repeat patient treatments are both very high compared to other doctors in this field.  I am very proud of this growth and the response of patients to the availability of cutting-edge aesthetic care in central Maine.  Next month, in cooperation with Allergan, we will be rolling out several promotions to help keep Botox and Juvederm affordable.  We will keep you posted as plans develop. Last but not least, I discussed Botox in more detail in an earlier post.  Because of these exciting developments I just detailed, I just posted that newsletter on our blog, so feel free to check that out if you have any further questions. Thanks again for reading this, and for your consistent support!  We will keep providing you with our great customer service.-This entry was originally written as an e-newsletter exclusively for our subscribers on September 21, 2008.  The information had been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have.

The Sun Is (STILL) Not Your Friend

It’s worth it to note that great summer weather isn’t fun for someone when sunburns are involved.  You’ll remember in a previous newsletter from last summer, “The Sun Is Not Your Friend”, I warned about the dangers of excess sun exposure in all seasons, including the wintertime.  Of course, exposure to the sun increases in the summer to a great degree because of changes in the Earth’s proximity to the sun in the Western hemisphere.  These changes result in increased ultraviolet rays released into the atmosphere. I write this warning not to scare you or to put a damper on your mood.  In fact, I guarantee that your summer, or whatever season it is, will be all the better if proper sunscreen is absorbed on the skin before going outside.  After all, ten minutes of applying the proper protection isn’t so much of an inconvenience compared to four days of intense burning, itching, and peeling of the skin.Furthermore, protection from the sun by sunblocks (SPF 30 or better) is also most important to protect from skin cancers and photoaging (i.e. premature wrinkles, blood vessels, age spots). If you’re still not convinced, consider this.  Last week, the National Institute of Health published a shocking study stating that over the past 20 years, cases of melanoma (the deadliest known form of skin cancer) in women have increased by nearly 50%.  This increase is thought to be due to increasing tanning booth usage, with the growth of the artificial tanning ndustry and outdoor exposure.  Men, for the record, were shown not to have any increase, which may be because of the limited number of males who engage in artificial tanning.I will wait until later to further delve into the other dangers of tanning booths.  But to reitterate, your best bet when stepping outside is to first apply sunblock with SPF 30 or better. Our brand of replenishing sunblock, for instance, provides guaranteed protection against burns and melanoma, and is good for your skin in other ways as well.-This entry was originally written as an e-newsletter exclusively for our subscribers on July 30, 2008.  The information has been edited to illiminate dated references, but the main points of the article, particularly the medical information, remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have. 

This entry was originally written as an e-newsletter exclusively for our subscribers on July 7, 2008.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have:

Rosacea- Part II: “Face Up” To Rosacea

I recently came to two realizations: 1.) I hadn’t written a monthly blog for the month of June, and 2.) I hadn’t written a follow-up to the post from October 2007, aptly named “Rosacea- Part I“.  Although I was probably taking a break from writing three newsletters in May [2008] alone, I still know that many of you were looking forward to the June newsletter, and I apologize again for the delay.  Having said that, this post serves as the ultimate catching up point for me as I bring you all more vital information on this serious but treatable skin condition.
 
It’s natural for people diagnosed with rosacea to feel isolated and embarassed by their skin.  However, everyone should know that rosacea is actually a very common skin condition.  An estimated 14 million Americans have rosacea in varying degrees.  In “Rosacea- Part I”, which can be found on our blog, I discussed many of the basics.
 
Women are affected by rosacea three times more frequently than men.  Common acute symptoms include flushing & red blotches appearing most commonly on the cheeks, nose, chin and forehead (in that order).
 
Broken blood vessels develop over time in addition to pimple-like bumps (acne rosacea).  In later and severe cases, rosacea can cause skin thickening with a characteristic swollen bumpy nose (most commonly seen in men).  Any rosacea patient knows that certain factors will trigger their flushing and make even mild rosacea look and feel worse.  Such common rosacea triggers include:

-Sun exposure
-Emotional stress
-Extremely hot or cold weather
-Humidity
-Excessive wind
-Excessive exercise
-Alcohol (especially red wine)
-Hot baths (including saunas)
-Spicy food
-Hot beverages
-Irritating skin treaments (especially any abrasive cleansers, dermabrasion & peels)

Obviously, avoiding these triggers can minimize flushing symptoms.  Unfortunately, once broken blood vessels develop, more active treatments are needed.  Topical treatments like Vitamin K can help stabilize these blood vessels.  Laser therapy currently remains the gold standard for both reducing broken vessels and preventing skin thickening.
 
If you have any specific questions about rosacea and its treaments, please call us at (207) 873-2158, e-mail us, or comment on our blog.  As always, product specials for each month are listed on our website. 

Thanks again for reading this, and for your continuing support!

This entry was originally written as an e-newsletter exclusively for our subscribers on May 26, 2008.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have: 

Botox Update

 I can only explain this additional blog post by how often inspiration hits me, not to mention general enthusiasm.  When I hear about important and exciting dermatolical news items, I can’t help but take a few moments to keep all my patients well informed.Having said that, I know we have discussed Botox a number of times in the past year, but new information keeps on coming to my attention that I feel needs to be further highlighted.  As you all know from reading the news or watching TV, Botox is now widely accepted socially.  Many everyday people (not just those on shows like Nip-Tuck) are very upfront about the fact that they use Botox to look and feel better.  From a medical standpoint, this trend is understandable and perfectly safe. A company representative of Allergan, the maker and distributor of Botox, recently visited us here at Maine Laser Skin Care because she saw that this small practice in central Maine was prescribing greater amounts of Botox than other larger practices.  To give you a general idea of her findings, her statistics showed that Botox use is increasing by about 20% nationwide and by 40% in New England.  However, Maine Laser Skin Care alone has increased its use of Botox over the past several years by 60% per year.Furthermore, after watching me perform several Botox treatments, the company representative felt that we treated our patients in a very consumer-friendly manner, explaining all the details of the treatment and making individual patients comfortable with the procedures and their choices.  Due to our increasing and approved use of Botox, you will be receiving promotional materials (compliments of the Allergan company) for additional discounts if you decide to use Botoxfor the first time, and for additional treatments as well. I can’t stress enough that Botox, when properly administered, is extremely safe and the effects are overwhelmingly appreciated by the patients.  If you have any questions concerning Botox or any of our other procedures, please do not hesitate to contact us through our website or call to make an appointment.  As always, product specials for each month are listed on our website. Thanks again for reading this, and for your consistent support!Sincerely,Dr. John Burke

This entry was originally written as an e-newsletter exclusively for our subscribers on May 12, 2008.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have:

Technology Advancements Part II

I am writing this blog to give you more information that I couldn’t quite fit into my last posting.  While I was at the conference in Orlando, I heard another interesting report from the Lupo Center for Aesthetic and General Dermatology, located in New Orleans.  Researchers from that institute were there discussing their studies on the treatment of severe nasolabial folds.  Nasolabial folds are the lines from your nose to the area down around your mouth that form especially as we all grow older.  Some people call them “parentheses lines” because they form into that semicircular line around your mouth.  
 
During this study, 87 patients were treated with with Juvederm Ultra Plus on one side of the face and collagen on the other, similar to demonstrations on television commercials.  The patients had a mean age of 49 years, and they were evaluated every 4 weeks for about six months using a 0-4 scale (with 4 indicating the most severe lines).  Before treatment, the average folds were rated as 3 in the study group.
 
Over the study period, the collagen-treated folds improved to an average of 2.5 while the Juvederm treated areas improved to an average of 1.3 (which is equivalent to a mild wrinkle).  96% of the Juvederm-treated wrinkles were considered clinically significant improvements, and 81% of the patients maintained the improvement for one year or longer. No serious treatment-related adverse side effects were noted.  This report adds to the growing and accepted evidence that Juvederm provides improvements in treatments from previous available products and also provides durable correction of severe nasolabial folds.
 
I have been using Juvaderm for nasolabial folds and other facial wrinkles since it was approved by the FDA in the past several years.  I too have had excellent results with high patient satisfaction, and this study further confirms my experience with this product.  If you have any questions concerning dermal fillers including Juvaderm, give us a call or send us an e-mail and I would be glad to discuss this information further.
 
In upcoming posts, I will provide you with plenty of information from the national laser meeting that I will share with you in the near future.  Summer is coming if it’s not here already.  And even though I stress that sunblock is necessary for every time of year (including winter), you will especially need it during the summer.  Hence, now is the time to stock up on it while it’s hot, particularly now since our brand of SPF-36 replenishing sunblock is on sale.

Thanks again for reading this, and for your consistent support!  You’ll be hearing from me again soon.

This entry was originally written as an e-newsletter exclusively for our subscribers on May 5, 2008.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have:

Recent and Potential Technology Advancements

Among my most recent endeavors that have kept me busy, I recently returned from Orlando where I attended the annual meeting of the prestigious American Society of Laser Medicine and Surgery.  This meeting is where experts worldwide update the latest advances in laser technology, and exchange ideas on new treatments for skin and tissue problems.  The weather was nice compared to the end of winter in Maine, although most of the daylight hours were unfortunately spent indoors.  However, I am proud to say that at this meeting, I was accepted into the ASLMS in recognition of my 5 years experience in laser medicine and skin care.  I look forward to an ongoing relationship with experts I met at this meeting, and I am seriously evaluating several new additions to my laser practice based on information I learned there.  Such potential advancements will include tattoo removal, new “blue light” therapy for acne and actinic keratoses (precancerous skin lesions), and new web-based technology for photo documentation of treatments.  More updates will be included in later posts as I continue to investigate these and other innovations introduced at that Orlando conference.
 
Among the new studies presented at the Orlando meeting was one concerning the use of the Nd:YAG 1064 laser, which is the Lyra laser used in our office, in treating mild to moderate acne scars.  The study, conducted by experts at the University of Sao Paulo in Brazil, had patients of all skin types ages 18-36 years old receiving 5 monthly treatments with the laser.  Mild to moderate improvements were observed in all patients, and a mean satisfaction rate of 8.8 out of 10 was reported.  In addition, nearly 92% of the patients graded their satisfaction as 8 to 10.  Side effects were limited to mild transient redness and increased skin sensitivity, but only immediately following the procedures.  The Brazilian doctors performed biopsies, which proved that the scars improved because of increased collagen production.  Collagen, by the way, is the foundation of smooth skin, which acts to smooth out deep scars from previous acne.
 
In other words, this study shows that the technology we are currently using continues to provide good results, and is in fact the state-of the-art way of treating acne scars.  The research also confirms what we see visually in that collagen production is stimulated, and as a result, scars become less deep and noticeable. 
 
As I’ve stated in previous newsletters, acne is best treated using multiple approaches, including laser & topical products.  There are several acne products that are on sale this month, if you’d like to take advantage of them.  As always, we have our very popular acne kit that can be ordered from our office or on our website at your convenience.  Just like the scientists in Brazil have shown, you can buy from us or set appointments with us with full confidence that your skin problems will be significantly reduced.  More advancements, not to mention blog posts, will be coming soon.  Thanks, and be sure to e-mail us with any questions you may have.

This entry was originally written as an e-newsletter exclusively for our subscribers on February 22, 2008.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have:

Winter Skin Part II

Earlier, I wrote a blog entry about the problem of winter skin and how to avoid it.  However, I continue to get questions about these problems, so I thought I’d revisit the subject about how to best protect yourself from winter skin.

I was trying to come up with an easy way to remember the basics one should know about preventing winter skin.  After much consideration, I have found that it all comes down to three letters:  E, M, and S.

E stands for Exfoliate.  During the winter, your skin becomes very dry because the winter air’s humidity is also very dry.  This gives your skin surface a very rough texture and also a rough appearance.  The dry skin also prevents moisture from getting below the surface of the skin.  The best way to diminish this dry skin is through exfoliation.  There are a number of products to exfoliate the skin gently, and I would recommend you check out the ones we have available on our website, especially if you have sensitive skin or have had skin treatments in the past.

M stands for Moisturize.  Once you have removed the dead, dry layers of skin, the live skin under the surface needs to have a certain level of moisture, or it will soon become dry and dead as well.  You can moisturize your skin internally by drinking lots of fluids which will maintain the hydration of your body as a whole in addition to the skin.  To keep the moisture in the healthy skin cells, moisturizers will help to retain the moisture and prevent the low humidity of the air from drying it out.  Again, we have a number of moisturizers on our website that we recommend.  There are also many over-the-counter moisturizers at local pharmacies that I highly recommended.  The best thing is to avoid any moisturizers that contain alcohol, which itself increases skin dryness.

S stands for Sun Protection, or Sunblock.  I know that I sound like a broken record, but I cannot stress enough that even winter sunlight can really be damaging to the skin, especially if the skin is dry and damaged to begin with.  For that reason, I recommend applying a minimum of SPF-30 sunblock to the face every day (Quick note:  our SPF-36 sunblock is on sale for the remainder of this month.).

So in summary, remember the letters EMS for Exfoliate, Moisturize, and Sunblock, and you will have the best skin possible to survive the winter and be ready for spring.  I know many of you are looking forward to the spring as much as I am.  Don’t forget to inform as many friends as possible about our products and this exclusive newsletter.  Thanks again for reading this and for your overall support, and more pertinent information will be coming to you soon.

Sincerely,

Dr. John Burke